The present invention relates in general to securing tracheostomy tubes and oral endotracheal tubes. More particularly, the present invention relates to a device for retaining such a tube in operational, patient contact.
Prior to 1983, the only method being used to any extent to secure a tracheostomy tube was strips of cotton fabric split at either end and then tied through the openings in the flange of the trache. Although reliable, it was extremely time consuming and tended to fray at the ends and roll up in a rope configuration which caused irritation to the patients neck. Wapner U.S. Pat. No. 4,331,144 addressed these problems.
Wapner U.S. Pat. No. '144 discloses a band which encircles the head and secures to itself using a hook and loop fastener. It also employs strips which thread through the slits in a trache flange and then secures back onto itself using hook and loop fasteners. This device currently is the only apparently viable arrangement available for securing a tracheostomy tube, other than the previously mentioned cotton strips.
while certainly functional, the Wapner device is also time consuming and can be extremely difficult to employ if the flange of the trache holder is pulled into folds of flesh as is often the case with overweight patients. To overcome this problem, the inward force normally required to hold the trache tube within the trachea must be reduced in order to allow the flanges to ride above the flesh folds. This scenario can result in the trache tube actually coming out of the stoma in the trachea.
In regards to securing oral endotracheal tubes, the generally practiced method is to use tape which is wrapped around a patient's neck and is then wrapped around the tube itself before being adhered to a patient's cheek for anchoring purposes. This technique is also time consuming and the tape needs to be replaced frequently due to saliva and blood which decreases the adhesive ability of the tape.
Addison U.S. Pat. No. 3,924,636 and Wapner U.S. Pat. No. 4,548,200 illustrate attempts to standardize and simplify the securing of oral endotracheal tubes. Addison U.S. Pat. No. '636 discloses a plastery with a central opening and a holding strap that is self-adhering. Wapner U.S. Pat. No. '200 discloses a device which employs a hook and loop fastener with adhesive backing which encircles the patient's head.
The Addison device, since it can stick to the patient's face by means of an adhesive plastery, cannot be used if the patient has any type of facial injury since it cannot be taped over a wound site, and the elliptical central opening does not prevent any lateral tube migration. Further, this device is not applicable to a tracheostomy tube.
In Wapner U.S. Pat. No. '200, since it employs a soft material in the region of the mouth, the tube holder would become stained and slippery in short order and would necessitate frequent replacement. It also is not applicable to tracheostomy tubes.
The present invention overcomes heretofore outstanding deficiencies existent in the state-of-the-art, as outlined above.